Provider Demographics
NPI:1679044366
Name:MACCHIARULO, MONICA (ATC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:MACCHIARULO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SAINT ALBANS DR APT 631
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-5890
Mailing Address - Country:US
Mailing Address - Phone:203-885-8898
Mailing Address - Fax:
Practice Address - Street 1:5601 ARRINGDON PARK DR STE 300
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-5676
Practice Address - Country:US
Practice Address - Phone:919-660-5066
Practice Address - Fax:919-660-5022
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-44242255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer